California Eyes Prohibiting Sale of MD Prescription Habits

Apr. 13--SANTA CRUZ -- Family physician Dean Kashino said he
doesn’t mind most of the friendly pharmaceutical
representatives who regularly stop by his office next to Dominican
Hospital.

But he finds it unnerving that they have a record of each drug
he chooses to prescribe to his patients.

"It seems odd that they can come in and say, You haven’t
prescribed our medication for a while. Why aren’t you
prescribing it?’" Kashino said Monday.

That’s why Kashino, with Dominican Medical Foundation,
said he supports a bill introduced by state Assemblyman Bill
Monning, D-Carmel, that would prohibit the sale of doctor
prescription habits for marketing purposes.

For drug companies to "see which doctors are treating cancers,
diabetes, that would be OK," Kashino said. "But what drugs
we’re prescribing, that goes outside those bounds."

Assembly Bill 2112 goes before the Assembly’s Committee on
Health today and follows efforts in other states to limit the
information available to drug makers that, some say, use the data
to push their products, not necessarily what’s best or most
cost-effective for patients. The bill is modeled after existing law
in New Hampshire.

Monning said access to a doctors’ prescribing habits
allows drug companies to target physicians who might be more
receptive to their sales pitches.

The California Medical Association and AARP California, among
other groups, have come out in favor of the bill.

Pharmaceutical industry groups

and so-called "data mining" companies -- third-party firms that
crunch and sell information obtained from pharmacies, doctor groups
and other sources -- have come out against it.

Drug companies argue that possessing an individual
physician’s prescribing data allows them to reach doctors
quickly and directly with unique information they might not
otherwise get.

"We want to make certain that doctors have the information they
need to safely and effectively treat their patients," said Ken
Johnson, senior vice president of Pharmaceutical Research and
Manufacturers of America, based in Washington, D.C. "With
safeguards in place to ensure proper use, prescriber data should be
available to America’s pharmaceutical research companies so
they can continue to provide important new information about
medicines to the physician community."

Industrywide spending on research and development topped $65.3
billion in 2009, according to figures provided by PhRMA. The
industry does not release exactly how much is spent on marketing. A
2008 study by researchers at York University in Canada estimated
the U.S. pharmaceutical industry spends about twice as much in
marketing as it does in research and development.

James Hinsdale, president-elect of the California Medical
Association, director of trauma at Marin General Hospital and
executive director of trauma at Regional Medical Center in San
Jose, said his group supports the limits proposed in
Monning’s legislation.

"This legislation is important because it removes one tool used
by drug companies to attempt to manipulate doctors’
decisions," Hinsdale said. "AB 2112 helps protect doctors and their
patients from overzealous drug companies."

Backers of the legislation say it would also help cut medical
costs, as doctors are less swayed to prescribe more expensive
medications. Studies done in 2007 by the Kaiser Family Foundation
show that average brand-name prescription prices were more than
three times that of average generic prices.

The bill proposes that those who break the law could be fined
$10,000 to $50,000 for each violation.

"The argument that the sales rep is doing altruistic work in
order to help the doctor make the best decision for his or her
patients doesn’t hold water for me," Monning said.

He said that doctors now can quickly check online databases for
peer-reviewed research of various drugs, which he said is more
reliable and accurate than a salesperson’s pitch.

Monning’s bill would not completely ban the sale of
doctors’ prescribing information, as that data can be crucial
for medical research, law enforcement investigations or drug recall
notifications, he said.

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